Clinical Advances in Periodontics最新文献

{"title":"Combining the tunneled coronally advanced flap (TCAF) with internal frenectomy-vestibular incision subperiosteal tunnel access (IF-VISTA) for the treatment of mandibular anterior gingival recessions: A technique report.","authors":"Maria das Graças Cruz Najar, Lorenzo Tavelli, Vanessa Frazao Cury, Shayan Barootchi","doi":"10.1002/cap.70104","DOIUrl":"https://doi.org/10.1002/cap.70104","url":null,"abstract":"<p><strong>Introduction: </strong>Gingival recession (GR) defects in the mandibular anterior region represent a particularly challenging scenario in periodontal plastic surgery, owing to a thin soft tissue phenotype, minimal keratinized tissue, limited vestibular depth, and the frequent presence of a prominent labial frenum. While significant advances have been made in root coverage procedures for the anterior mandible, simultaneously addressing these coexisting anatomical factors in a single, minimally invasive procedure remains a clinical challenge.</p><p><strong>Methods: </strong>This technique report describes the combined application of the tunneled coronally advanced flap (TCAF) with the internal frenectomy-vestibular incision subperiosteal tunnel access (IF-VISTA) and connective tissue graft for the treatment of multiple mandibular anterior GRs in two systemically and periodontally healthy, non-smoking patients. The TCAF framework guided site-specific papilla management, while the IF-VISTA provided internal frenectomy, vestibular deepening, and expanded subperiosteal access through a single minimally invasive incision.</p><p><strong>Results: </strong>Healing was uneventful, with limited postoperative morbidity. At 10-12 months, complete root coverage was observed at most treated sites in the two cases, accompanied by an increase in soft tissue phenotype, papilla fill, and resolution of dentinal hypersensitivity.</p><p><strong>Conclusions: </strong>The TCAF + IF-VISTA combination addresses, within a single procedure, the multiple anatomical factors most commonly compromising outcomes in the mandibular anterior region, including mandibular midline frenum pull, limited vestibular depth, and restricted surgical access. The synergy between the two approaches facilitates tension-free flap advancement, precise graft insertion, simultaneous frenulum elimination, and preservation of papillary integrity. Prospective controlled studies are needed to validate the long-term outcomes and reproducibility of this technique.</p><p><strong>Key points: </strong>The combination of tunneled coronally advanced flap (TCAF) with the internal frenectomy-vestibular incision subperiosteal tunnel access (IF-VISTA) allows clinicians to address, in a single surgical procedure, the multiple anatomical factors most commonly associated with mandibular anterior gingival recessions, including limited vestibular depth, high mandibular midline frenum insertion, and restricted surgical access. The internal frenectomy component of IF-VISTA eliminates the mandibular midline frenum attachment through a closed, scarless approach, avoiding the morbidity associated with conventional open frenectomy while simultaneously enhancing coronal flap mobility and tension-free tissue advancement. The TCAF decision-making framework allows site-specific adaptation of the flap design-selectively incising or tunneling each papilla based on its morphology and the local anatomy-making this combined","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Horizontal ridge augmentation with demineralized allograft layered with xenograft - A prospective cohort study.","authors":"Eswar Kandaswamy, Panagiotis Dragonas, Katherine Carmona, Hari Prasad, Jeanne St Germain, Vinayak Joshi, Zixin Li, Qingzhao Yu","doi":"10.1002/cap.70108","DOIUrl":"https://doi.org/10.1002/cap.70108","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated clinical, radiographic, and histologic outcomes of horizontal ridge augmentation using a layering technique with demineralized freeze-dried bone allograft (DFDBA) internally and deproteinized bovine bone mineral (DBBM) buccally, covered by a native bilayer collagen membrane. Primary outcomes included horizontal bone gain, graft shrinkage, and vital bone formation.</p><p><strong>Methods: </strong>In this prospective single-arm study, adult patients requiring horizontal ridge augmentation prior to implant placement were treated with the layering technique (DFDBA and DBBM). Cone beam computed tomography scans were obtained preoperatively (T0), immediately postoperatively (Tim), and after 6-9 months (T2). Ridge widths were measured at 3, 5, and 7 mm apical to the crest. Linear mixed-effects models assessed dimensional changes and the influence of the DFDBA:DBBM ratio on the outcomes. Bone core biopsies were collected at implant placement for histologic and histomorphometric analysis.</p><p><strong>Results: </strong>Fifteen patients completed the study. Mean horizontal bone gain was 3.68 ± 1.20, 3.98 ± 1.56, and 3.91 ± 1.77 mm (all p < 0.001) at 3, 5, and 7 mm respectively. Linear graft shrinkage was 1.76 ± 0.95, 1.82 ± 1.11, and 1.72 ± 0.96 mm at the respective levels (all p < 0.001). A higher DFDBA:DBBM ratio significantly increased shrinkage at 3 mm (p = 0.015). Histology (n = 7) showed 30.97 ± 16.71% vital bone, 21.41 ± 10.63% residual graft, and 47.62 ± 18.51% marrow/connective tissue.</p><p><strong>Conclusion: </strong>The DFDBA-DBBM layering technique achieved significant horizontal bone gain with predictable modelling and favorable vital bone formation, supporting its use as a viable augmentation approach pending further comparative studies.</p><p><strong>Key points: </strong>The layering technique of internal demineralized freeze-dried bone allograft and outer deproteinized bovine bone mineral for guided bone regeneration predictably increased horizontal ridge width, resulting in approximately 3.6 - 4 mm of horizontal bone gain. The technique demonstrated favorable dimensional stability with graft shrinkage of approximately 1.7-1.8 mm. The augmented sites showed clinically relevant amounts of vital bone formation (approximately 31%), supporting the biological effectiveness of the layered grafting strategy.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term stability after non-surgical furcation retreatment with adjunctive collagen hydrogel.","authors":"Marisa Roncati, Lucrezia Parma-Benfenati","doi":"10.1002/cap.70118","DOIUrl":"https://doi.org/10.1002/cap.70118","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Management of inflammation at previously surgically treated periodontal sites represents a clinical challenge. Although surgical retreatment may be indicated in selected cases, a conservative non-surgical approach may restore periodontal stability while avoiding the additional morbidity associated with repeated surgery. This case report describes the long-term management of a previously surgically treated mandibular molar furcation using site-specific non-surgical retreatment combined with adjunctive application of a collagen-based hydrogel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 45-year-old non-smoking male with a history of stage III, grade B periodontitis presented with persistent inflammation at a previously surgically treated mandibular first molar. Clinical examination revealed a 4-mm mid-buccal probing depth associated with bleeding on probing and Grade II furcation involvement. Following comprehensive periodontal re-evaluation, the site was managed by meticulous non-surgical re-instrumentation and adjunctive application of a collagen-based hydrogel as a conservative alternative before considering surgical re-intervention. The patient was subsequently enrolled in an individualized supportive periodontal care program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Bleeding on probing resolved within 25 days and remained absent throughout the 6-year follow-up. Probing depth progressively decreased from 4 to 2 mm, while the previously inflamed furcation site became clinically stable and maintainable without requiring additional periodontal surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Within the limitations of a single case report, this case illustrates that a carefully executed conservative retreatment strategy, combining meticulous non-surgical periodontal therapy, individualized supportive periodontal care, and adjunctive collagen hydrogel application, may successfully restore and maintain periodontal stability at a previously surgically treated furcation site while avoiding surgical re-intervention. Controlled prospective studies are required to clarify the clinical contribution of adjunctive collagen hydrogels in the management of persistent periodontal defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Non-surgical re-instrumentation may be considered before surgical re-intervention in selected previously treated periodontal sites, provided that the clinical response is carefully re-evaluated. Molar furcation anatomy may limit non-surgical instrumentation; periodontal surgery remains indicated when adequate access and control of inflammation cannot be achieved through a conservative approach. In this case, periodontal stability was maintained for 6 years within an individualized supportive periodontal care program; the independent contribution of the adjunctive collagen hydrogel cannot be determined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Periodontal disease can leave areas around teeth that are difficult to keep healthy, pa","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified palatal strip grafting for keratinized tissue augmentation: A technical report.","authors":"Vikender S Yadav, Mumtaz Ali, Anuppriyanka Ilango, Kalaiselvan Dharani","doi":"10.1002/cap.70102","DOIUrl":"https://doi.org/10.1002/cap.70102","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Previously reported techniques on strip grafting have utilized either multiple palatal strips or a single palatal strip in conjunction with a collagen matrix, and have primarily been described for increasing the peri-implant keratinized mucosa width. However, the application of a palatal strip graft for keratinized tissue (KT) augmentation around teeth has not been reported to date. This technical report describes a modified approach to augment KT around teeth using a single palatal strip without adjunctive use of biomaterials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The modified palatal strip graft (mPSG) technique follows a standardized surgical protocol for recipient bed preparation (three distinct zones), donor site management (harvesting of a 3 mm wide palatal strip and closure with sutures only) and graft stabilization using lateral sutures at extremities of graft and compressive horizontal mattress sutures by engaging the connective tissue zones coronal (zone 1) and apical (zone 3) to the graft placed in zone 2 of recipient site. A representative case, supplemented by additional clinical illustrations, is presented to demonstrate the surgical steps and clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Clinical observations demonstrated an increase in attached keratinized gingiva and vestibular depth around treated teeth. In addition, limited postoperative pain (severity and duration), absence of delayed bleeding, and faster healing (complete epithelialization achieved within 2 weeks) at the donor site were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The mPSG approach seems to be predictable, cost-effective, and \"patient-friendly\" for KT augmentation around teeth. Nevertheless, comparative randomized clinical trials are suggested to confirm the observations presented here.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The modified palatal strip graft (mPSG) technique provides a practical approach for simultaneous keratinized tissue augmentation and vestibular deepening around teeth using a single palatal strip graft. The technique eliminates the need for adjunctive biomaterials and may reduce donor-site morbidity and treatment-related costs, though it requires careful case selection, utilizing microsurgical principles and advanced surgical skills for successful outcomes. The mPSG approach may be particularly useful in patients with limited palatal donor tissue, such as adolescents and individuals with a shallow palatal vault, where harvesting a conventional free gingival graft may be challenging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Some patients have an insufficient amount of firm gum tissue around their teeth, making oral hygiene more difficult and increasing the likelihood of gum inflammation and discomfort during brushing. The most commonly used treatment to increase this tissue is a free gingival graft, which involves harvesting tissue from the palate. Although effective, this procedure can result in postoperat","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-sided entire papilla preservation for mandibular distal furcation defect: A case report.","authors":"Takayoshi Nagahara, Tomoyuki Iwata, Yukiko Nagatani, Masaru Shimizu, Fuminori Nakashima, Kazuhisa Ouhara, Noriyoshi Mizuno","doi":"10.1002/cap.70112","DOIUrl":"https://doi.org/10.1002/cap.70112","url":null,"abstract":"<p><strong>Background: </strong>Distal furcation-associated intrabony defects in mandibular molars are difficult to manage because of limited surgical access, restricted visibility, and complex root anatomy. This case report describes the regenerative management of a distal furcation-associated intrabony defect in a mandibular first molar using recombinant human fibroblast growth factor-2 (rhFGF-2) with a double-sided entire papilla preservation technique-based approach (DEPPT-BA).</p><p><strong>Methods: </strong>A 56-year-old systemically healthy woman presented with stage III, grade B periodontitis and Hamp Class II distal furcation involvement of the mandibular left first molar, with a maximum probing pocket depth (PPD) of 8 mm. After initial periodontal and endodontic therapy, periodontal regenerative surgery was performed using the DEPPT-BA to obtain buccal and lingual access while preserving the interdental papilla. rhFGF-2 was applied to the defect without adjunctive bone graft material.</p><p><strong>Results: </strong>Healing progressed without major complications. At 12 months postoperatively, PPDs were ≤2 mm at all sites, bleeding on probing was absent, and the distal furcation involvement was clinically resolved without gingival recession. Cone-beam computed tomography demonstrated substantial bone fill within the intrabony defect and clinical resolution of the distal furcation involvement.</p><p><strong>Conclusions: </strong>Within the limitations of a single case report, this application of DEPPT-BA combined with rhFGF-2 may improve buccal and lingual access while maintaining interdental soft-tissue stability in distal furcation-associated intrabony defects with buccolingual extension in mandibular molars.</p><p><strong>Key points: </strong>Distal furcation-associated intrabony defects in mandibular molars pose considerable regenerative challenges, given limited access, restricted visibility, and complex root anatomy. DEPPT-BA provided buccal and lingual access to the distal furcation defect while preserving the interdental papilla and maintaining wound stability. Favorable 12-month clinical and radiographic outcomes were achieved using rhFGF-2 without adjunctive bone grafting material.</p><p><strong>Plain language summary: </strong>This case report describes the treatment of a difficult periodontal defect affecting the distal furcation area of a mandibular molar using DEPPT with rhFGF-2. The technique improved surgical access while maintaining soft-tissue stability, resulting in favorable clinical healing and substantial bone fill at 12 months.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digitally customized bone block allograft with enamel matrix derivative for ridge reconstruction: Case series. Histological report in humans.","authors":"Facundo Caride, Juliana Bugiolachi, Luciana M Sánchez, Gisela E Pulitano Manisagian, Mariela Lacave, Federico G Galli, Hernán Bontá","doi":"10.1002/cap.70115","DOIUrl":"https://doi.org/10.1002/cap.70115","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Alveolar ridge resorption following tooth extraction is a common clinical challenge that can compromise esthetics, implant placement, and prosthetic rehabilitation. Digital customization of bone block allografts offers precise adaptation to the recipient site, improving graft stability and reducing surgical time. Enamel matrix derivative (EMD) has demonstrated potential to enhance osteogenic differentiation and cell adhesion; however, its application in combination with digitally customized bone block allografts (DCBBAs) remains scarcely reported. This study aimed to evaluate, bone regeneration following alveolar ridge reconstruction using a DCBBA combined with EMD through histologic and histomorphometric analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Three systemically healthy, non-smoking patients with severe Seibert Class III ridge defects were treated using a DCBBA with adjunctive EMD. Grafts were digitally planned and milled based on CBCT data to achieve an ideal fit. EMD was applied to both the graft and recipient site before fixation. After 6 months of healing, re-entry surgery was performed for implant placement, during which six bone biopsies were obtained for histologic and histomorphometric evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Clinically, all grafts exhibited stable integration without signs of inflammation or necrosis. Histological analysis revealed new bone formation in close contact with residual allograft particles, with viable osteocytes and osteoblasts throughout the regenerated area. Histomorphometric evaluation confirmed a predominance of mineralized bone tissue, consistent with active bone remodeling.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Within the limitations of this case series, the combination of DCBBAs and EMD demonstrated favorable graft integration and bone regeneration, supporting its potential as a predictable approach for reconstructing severe alveolar ridge defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Digitally customized bone block allografts combined with enamel matrix derivative achieved stable clinical integration without complications in severe Seibert Class III ridge defects. Histological analysis demonstrated intimate contact between newly formed vital bone and residual allograft, with viable osteocytes and active osteoblasts throughout the regenerated area. Histomorphometric evaluation showed a predominance of mineralized bone tissue after 6 months, indicating active remodeling and graft replacement by vital bone. The digitally customized workflow allowed precise graft adaptation, potentially reducing surgical time and improving biological integration in complex ridge reconstructions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Following tooth loss, the jawbone gradually loses volume, which can make dental implant treatment difficult or even impossible without prior bone reconstruction. This study evaluated a regenerative approach that combines digitally customized donor bon","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tooth autotransplantation combined with bone augmentation for reconstruction of the esthetic zone: A case report.","authors":"Gurgen Khachatryan, Joseph Kan, Ekaterina Zernitckaia, Ulvi Shirnaliev","doi":"10.1002/cap.70109","DOIUrl":"https://doi.org/10.1002/cap.70109","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of cleft-associated defects in the anterior maxilla is complicated by deficient hard and soft tissues, scarring, and altered anatomy. This case report describes tooth autotransplantation with simultaneous autogenous bone augmentation for replacement of a congenitally absent maxillary lateral incisor.</p><p><strong>Methods: </strong>A 20-year-old male with agenesis of tooth #10 and previous cleft lip repair presented after 4 years of removable prosthesis use. Examination revealed horizontal and vertical ridge deficiency and residual oronasal communication. After surgical closure of the communication, tooth #20 was autotransplanted to site #10 following extraoral apical resection. Thin autogenous cortical plates and particulate bone harvested from the maxillary tuberosity were used simultaneously to augment the facial defect. An implant was subsequently placed at the donor site. Root canal treatment, direct composite restoration, and subsequent connective-tissue augmentation completed the rehabilitation.</p><p><strong>Results: </strong>At 12 months, the transplanted tooth remained functional and demonstrated grade I mobility, probing depths of 1.5-2.0 mm, and no bleeding on probing. No definite inflammatory or replacement root resorption was identified radiographically. The soft-tissue contour was improved, although partial remodeling of the augmented facial bone was evident.</p><p><strong>Conclusion: </strong>Within the limitations of this case report, tooth autotransplantation with simultaneous autogenous bone augmentation allowed fixed tooth replacement and reconstruction of the deficient recipient site. This combined approach may represent a clinically relevant option in carefully selected patients when the available bone is insufficient for autotransplantation alone. Longer follow-up is required to assess its stability and long-term prognosis.</p><p><strong>Key points: </strong>Digital planning and a printed donor-tooth replica facilitated donor selection and recipient-site preparation while limiting extraoral manipulation of the transplanted tooth. Simultaneous augmentation with thin autogenous cortical plates and particulate bone may support tooth autotransplantation when the available recipient-site bone is insufficient, although graft remodeling should be anticipated. Autotransplantation of a tooth with complete root formation requires careful surgical handling, appropriate endodontic management, and long-term monitoring for root resorption and ankylosis.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preformed titanium mesh for posterior maxillary reconstruction with regenerative strategies: Two cases.","authors":"Sean Lee, Yi-Chu Wu","doi":"10.1002/cap.70116","DOIUrl":"https://doi.org/10.1002/cap.70116","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Posterior maxillary reconstruction often requires simultaneous management of ridge deficiency, sinus pneumatization, and localized periodontal defects within the same surgical field. This report describes an indirect preformed titanium mesh workflow that supports individualized posterior maxillary reconstruction through defect-specific sinus elevation and periodontal regenerative strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In two patients, titanium mesh was adapted extraorally on a patient-specific 3D-printed model before surgery to improve graft contour control and reduce intraoperative mesh adjustment. The first case combined simultaneous lateral sinus elevation with vertical ridge augmentation and adjacent enamel matrix derivative-assisted periodontal regeneration. The second case followed a staged approach consisting of vertical ridge reconstruction with membrane-based guided tissue regeneration, followed by transcrestal sinus elevation and implant placement at reentry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Reentry demonstrated favorable hard tissue regeneration, permitting stable implant placement and successful prosthetic rehabilitation in both cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;An indirect preformed titanium mesh workflow may facilitate individualized posterior maxillary reconstruction by providing predictable space maintenance while allowing sinus elevation and periodontal regenerative strategies to be tailored according to defect characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;An indirect preformed titanium mesh workflow reduces intraoperative mesh adjustment while maintaining predictable space for bone regeneration. Selection of lateral or transcrestal sinus elevation should be based on the anticipated residual bone height after vertical ridge reconstruction. When periodontal defects are present adjacent to the reconstruction site, regenerative therapy should be tailored to defect morphology and integrated into the surgical plan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Rebuilding bone in the back part of the upper jaw for dental implant placement can be challenging because many patients have lost a large amount of bone, the nearby sinus has expanded, and the teeth next to the missing area may also have damaged supporting tissues. This report describes a digital workflow that uses a patient-specific 3D-printed model to shape a titanium mesh before surgery. Preparing the mesh in advance reduces the need for adjustments during the operation and helps maintain the space needed for new bone to grow. The same workflow was adapted to each patient's condition. Depending on the amount of available bone, sinus elevation was performed either during the initial surgery or later at the time of implant placement. Depending on the type of periodontal defect, the most appropriate regenerative treatment was performed during the initial surgery. In both patients, sufficient new bone was regenerated for success","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthodontic, regenerative, and implant management of a mandibular anterior defect: 5-year outcome.","authors":"Jia Yuan, Andrea Laureti, Zhihui Mai, Hom-Lay Wang","doi":"10.1002/cap.70117","DOIUrl":"https://doi.org/10.1002/cap.70117","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Severe alveolar ridge defects in the mandibular anterior region, often associated with congenital tooth absence and subsequent loss of retained primary teeth, present significant challenges for implant rehabilitation. Limited space, horizontal ridge deficiency, and complex site anatomy often require a multidisciplinary approach to achieve stable hard- and soft-tissue outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 30-year-old woman presented with absence of teeth #23 and #25, distal rotation of tooth #24, and insufficient mesiodistal space for implant placement. After 15 months of orthodontic space creation, severe horizontal ridge deficiency was confirmed clinically and by cone-beam computed tomography (CBCT). A single-stage surgical protocol was performed consisting of implant placement with guided bone regeneration (GBR) at sites #23 and #25 and guided tissue regeneration (GTR) at adjacent teeth #24 and #26. Deproteinized bovine bone mineral and an absorbable collagen membrane were used for defect regeneration, followed by tension-free primary closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Healing was uneventful. At the 5-year follow-up, clinical and radiographic evaluation demonstrated stable buccolingual ridge dimensions, adequate keratinized mucosa, and healthy peri-implant soft-tissue contours. CBCT confirmed maintenance of regenerated bone at the implant sites and adjacent natural teeth, with no evidence of mucosal or gingival recession and preserved bone volume.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case illustrates that a coordinated approach involving orthodontic space creation followed by implant placement with simultaneous GBR and GTR may support long-term rehabilitation of mandibular anterior defects. Stable hard- and soft-tissue conditions and favorable functional and esthetic outcomes were maintained over a 5-year follow-up. The simultaneous use of GBR and GTR at adjacent implant and natural-tooth sites, documented over 5 years, distinguishes this case from conventional staged approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Orthodontic space creation is often essential for prosthetically driven implant placement in mandibular anterior mesiodistal defects. Simultaneous guided bone regeneration and guided tissue regeneration can allow reconstruction of combined implant- and tooth-related defects. Performing regenerative procedures and implant placement during a single surgical intervention reduces the number of surgeries for the patient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Missing teeth in the front lower jaw can be challenging to replace when there is not enough bone to support implants and when nearby natural teeth have developed supporting tissue problems related to orthodontic treatment. This case report describes the treatment of a patient with missing teeth who first received orthodontic treatment to create enough space for implants. The patient then received dental implants along with procedu","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intentional replantation of periodontally compromised teeth with concentrated growth factors","authors":"Nabeel Ayappali Kalluvalappil,&nbsp;R. Saravana Kumar,&nbsp;Tamer Hamed Hassan","doi":"10.1002/cap.70017","DOIUrl":"10.1002/cap.70017","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Intentional replantation (IR) has been described as a potential treatment modality for periodontally compromised anterior teeth deemed hopeless, particularly when combined with regenerative biomaterials such as concentrated growth factor (CGF). However, high-level evidence documenting cone-beam computed tomography (CBCT)-based outcomes in such cases remains limited. This paper evaluates the clinical and radiographic outcomes of IR using CGF in anterior teeth with advanced periodontal bone loss over a 1-year follow-up period.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ten patients with single-rooted anterior teeth exhibiting advanced periodontal disease underwent atraumatic extraction, extraoral debridement, CGF application to both socket and root surface, and immediate replantation followed by semi-rigid splinting for 4 weeks. Clinical parameters (probing depth [PD], mobility, and gingival index), patient-centered outcomes (pain scores and oral health-related quality of life), and CBCT imaging were assessed at baseline and 12 months postoperatively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;All cases showed favorable clinical healing, with significant reductions in mobility and PD. CBCT analysis revealed a mean gain in alveolar bone height of 2.58  ±  0.43 mm from baseline to 12 months. Pain was reduced significantly (mean pain scores (Visual Analog Scale) changed from 6.1 ± 0.7 to 0.6 ± 0.5). Oral Health Impact Profile-14 (OHIP-14) scores improved from 18.9 ± 1.32 to 4.6 ± 0.54. No cases of root resorption or ankylosis were observed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Within the limitations of this case study without controls, IR using CGF was associated with clinically stable outcomes and radiographic evidence of bone fill at 1 year in these selected cases. This approach may be considered a potential alternative to extraction in specific clinical scenarios.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;NCT06893107; US National Institutes of Health Clinical Trials Registry&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Intentional replantation (deliberate removal of teeth, extraoral treatment, and reinsertion into the same socket) can be considered a conservative approach to preserve anterior teeth with severe periodontal compromise.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The addition of concentrated growth factor during this cl","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"513-521"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}